MEDICARE: MR. CARL L SCHMITZER MSW LCSW PIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	254	SD

General Provider Information

NPI Number	:	1538152384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL L SCHMITZER MSW LCSW PIP

Provider Business Mailing Address
First Line	:	5000 S MINNESOTA AVE
Second Line	:	SUITE 200
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2707
Country	:	US
Telephone Number	:	605-271-1348
Fax Number	:	605-610-1477

Provider Business Practice Location Address
First Line	:	5000 S MINNESOTA AVE
Second Line	:	SUITE 200
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2707
Country	:	US
Telephone Number	:	605-271-1348
Fax Number	:	605-610-1477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	03/10/2009

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